1
|
Erdost ŞK, Gözen D. The effect of position on feeding performance in infants with cleft lip and palate: Quasiexperimental study. J SPEC PEDIATR NURS 2024; 29:e12428. [PMID: 38800888 DOI: 10.1111/jspn.12428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 04/22/2024] [Accepted: 05/06/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE This single-group, quasiexperimental study was conducted to determine the effect of feeding position on the physiological parameters and feeding performance of term-born infants with cleft lip and palate (CLP) in the preoperative period. METHODS The study sample consisted of 45 infants aged 0-6 months with CLP followed up preoperatively in our outpatient clinic between January 2021 and 2022. Infants who were being fed with a specialty bottle for babies with CLP and whose families consented to participate in the study were included. After 2 h of fasting, the infants were fed in the elevated supine (ESU) position for the first meal, then in the elevated side-lying (ESL) position for the second meal after another 2 h of fasting. The infants' heart rate and oxygen saturation values before, during, and after each feed and indicators of feeding performance were compared between the positions. RESULTS There was no significant difference between the positions in terms of heart rate and oxygen saturation before, during, or after feeding (p > .05). There was no statistically significant difference in measures of feeding performance according to the infants' feeding position (p > .05). CONCLUSION According to the findings obtained in this study, infants with CLP showed no statistically significant differences in heart rate, oxygen saturation, or feeding performance when fed in the ESL and ESU positions. PRACTICE IMPLICATIONS However, despite the lack of statistical significance, both physiological values and feeding performance tended to be better when the infants were fed in the ESL position, nurses can practice ESL position according to the infant's opposite direction of the side of the cleft lip or palate.
Collapse
Affiliation(s)
- Şerife Kartal Erdost
- Health Science Faculty, Department of Nursing, İstanbul Kültür University, Istanbul, Turkey
| | - Duygu Gözen
- Pediatric Nursing, School of Nursing, Koç University, Istanbul, Turkey
| |
Collapse
|
2
|
Kotlarek KJ, Benson M, Williams J. Current Practice Patterns and Training Pathways for Feeding Infants with Cleft Palate. Cleft Palate Craniofac J 2024; 61:1018-1026. [PMID: 36683489 DOI: 10.1177/10556656231152358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE To examine the current trends and practices across disciplines for feeding infants with cleft palate with or without cleft lip and to describe provider training within this area. DESIGN Prospective survey. SETTING ACPA approved cleft palate teams and healthcare providers in the United States and Canada. PARTICIPANTS Interdisciplinary providers that regularly provide feeding services to infants with cleft palate. INTERVENTION 50-item survey designed and distributed electronically via the ACPA. MAIN OUTCOME MEASURES Information on provider demographics and practice patterns. RESULTS 76 respondents included providers in North America that have either currently or previously served on a cleft palate team. The majority of respondents were in speech-language pathology (49%) or nursing (38%) disciplines, worked in an outpatient setting (70%), and received no information (68%) regarding cleft palate feeding in their academic training. While specific practice patterns were relatively consistent across the respondent cohort, provider characteristics were significantly associated with squeezing the Haberman (p = .013) and likelihood of collaboration with other providers when counseling parents/caregivers (p = .039). CONCLUSIONS While provider characteristics varied, there were similar practice patterns observed across disciplines. Future research is needed explore training related to feeding knowledge as well as practice patterns in locations with a lower patient volume.
Collapse
Affiliation(s)
- Katelyn J Kotlarek
- Division of Communication Disorders, University of Wyoming, Laramie, WY, USA
| | - Mikayla Benson
- Division of Communication Disorders, University of Wyoming, Laramie, WY, USA
| | - Jessica Williams
- Phoenix Children's Center for Cleft and Craniofacial Care, Phoenix, AZ, USA
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| |
Collapse
|
3
|
McKinney CM, Howard W, Bijlani K, Rahman M, Meehan A, Evans KN, Leavitt D, Sitzman TJ, Amoako-Yirenkyi P, Heike CL. Growth Patterns Between Ages 0 and 36 Months Among US Children With Orofacial Cleft: A Retrospective Cohort Study. J Acad Nutr Diet 2024:S2212-2672(24)00251-X. [PMID: 38801990 DOI: 10.1016/j.jand.2024.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Little is known about how young children with orofacial cleft grow over time. OBJECTIVE To characterize longitudinal growth patterns from ages 0 to 36 months in US children with an orofacial cleft. DESIGN A retrospective cohort study. PARTICIPANTS/SETTING Children with cleft lip, cleft lip and palate, or cleft palate who were younger than age 36 months at a hospital encounter between 2010 and 2019 (N = 1334) were included. The setting was a US tertiary care children's hospital with a cleft center that serves a 5-state region. MAIN OUTCOME MEASURE Weight-for-age z scores (WAZ) and length-for-age z scores (LAZ). STATISTICAL ANALYSES PERFORMED Longitudinal growth patterns were characterized using generalized linear mixed models to estimate mean WAZ and LAZ from age 0 to 36 months. RESULTS Growth in infants with cleft slowed dramatically during the first 3 to 4 months of life, rebounded with catch-up growth until age 12 months for cleft lip and cleft palate and until age 36 months for cleft lip and palate. When comparing populations, children with any type of cleft demonstrated subpar growth compared with World Health Organization standards. Growth deficits were more common in those with cleft lip and palate and cleft palate compared with those with cleft lip. The intraclass coefficient showed that most of the variability in the WAZ (65%) was between individuals, whereas 35% was within an individual. The intraclass coefficient for LAZ showed that most of the variability in the LAZ (74%) was between individuals, whereas 26% was within an individual. The proportion of variance attributable to cleft type and/or comorbidities accounted for <5% of the variance for WAZ and LAZ. WAZ and LAZ were lower in children with comorbidities than those without comorbidities with cleft and World Health Organization standards. CONCLUSIONS Infants with cleft lip and palate, cleft palate, and a cleft with comorbidities have higher rates of poor growth than peers with cleft lip and a cleft with no comorbidities, respectively.
Collapse
Affiliation(s)
- Christy M McKinney
- Seattle Children's Research Institute, Seattle, Washington; Seattle Children's Hospital, Seattle, Washington; University of Washington, Seattle, Washington.
| | - Waylon Howard
- Seattle Children's Research Institute, Seattle, Washington; Seattle Children's Hospital, Seattle, Washington
| | - Kiley Bijlani
- Seattle Children's Research Institute, Seattle, Washington; Seattle Children's Hospital, Seattle, Washington
| | - Muhammad Rahman
- Seattle Children's Research Institute, Seattle, Washington; University of Washington, Seattle, Washington
| | - Anna Meehan
- Seattle Children's Research Institute, Seattle, Washington; Seattle Children's Hospital, Seattle, Washington
| | - Kelly N Evans
- Seattle Children's Research Institute, Seattle, Washington; Seattle Children's Hospital, Seattle, Washington; University of Washington, Seattle, Washington
| | - Dawn Leavitt
- Seattle Children's Hospital, Seattle, Washington
| | | | | | - Carrie L Heike
- Seattle Children's Research Institute, Seattle, Washington; Seattle Children's Hospital, Seattle, Washington; University of Washington, Seattle, Washington
| |
Collapse
|
4
|
Penny C, Nugent KA, Gilgan H, Bezuhly M. Comparison of two Specialized Cleft Palate Feeders. Cleft Palate Craniofac J 2024; 61:443-449. [PMID: 36217739 PMCID: PMC10893773 DOI: 10.1177/10556656221129977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To evaluate feeding efficiency and weight gain in infants with cleft palate fed using 1 of the 2 specialty feeders. DESIGN Retrospective cohort study. SETTING Cleft palate clinic in a tertiary pediatric hospital. PARTICIPANTS Infants with cleft palate (with or without cleft lip) fed using the Medela SpecialNeeds® Feeder (n = 39) or the Dr. Brown's® Specialty Feeding System (n = 16) and who had documented feeding and growth data available from the time of initial assessment in the first month of life and at subsequent follow-up between 2 and 4 months. PRIMARY OUTCOME MEASURE Feeding velocity (mL/min). SECONDARY OUTCOMES MEASURES Calorie velocity (kcal/min), weight gain, and complications associated with poor feeding. RESULTS No statistically significant differences in feeding or calorie velocities were identified between infants with cleft palate fed with the Medela SpecialNeeds® feeder and those fed with the Dr. Brown's® feeder. Mean weight z-scores by month did not differ significantly between the 2 bottle groups at the time of initial assessment (P = .84) and follow-up (P = .20). Mean weight z-scores by month for the infants included in this study fell below the 50th percentile. The proportion of infants who developed otitis media, reflux requiring treatment, or who required hospital admission for nasogastric (NG) feeds did not differ significantly between the 2 groups. CONCLUSIONS Despite being adequately powered for the primary outcome, no significant differences were identified between infants fed with the Medela or the Dr. Brown's feeders in terms of feeding velocity, calorie velocity, weight gain, or complications.
Collapse
Affiliation(s)
- Cameron Penny
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | - Michael Bezuhly
- Division of Plastic Surgery and Reconstructive Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
5
|
Tahmasebifard N, Perry JL, O'Brien K, Briley PM. Attributes That Increase Vulnerabilities to Reduced Human Milk Feeding Outcomes Among Babies With Cleft Lip and Palate in the Neonatal Intensive Care Unit. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:49-58. [PMID: 37983129 DOI: 10.1044/2023_jslhr-23-00367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
OBJECTIVE The purpose of this study was to identify infant and maternal factors associated with reduced human milk feeding among infants in a neonatal intensive care unit (NICU) with cleft lip with or without cleft palate (CL ± P). METHOD Data collected on mothers and infants admitted to the NICU with CL ± P from the 2018 National Vital Statistics System were used for this study. Chi-square tests of independence and independent-samples t tests were used to compare categorical variables and continuous variables, respectively, among two groups of infants admitted to the NICU with CL ± P-those who did and did not receive human milk feeding at discharge. RESULTS The sample included 660 infants admitted to the NICU with CL ± P, of which 353 received human milk at discharge. Significant differences were found between the two groups for marital status, mother's education, maternal smoking record, total number of prenatal visits, multiparity record, gestational age, birth weight, and use of assisted ventilation. CONCLUSIONS Results indicated that, as a function of human milk feeding at discharge, mothers and their infants admitted to the NICU with CL ± P exhibited differences across infant and maternal factors. These findings further our understanding of this sample of mothers and infants with CL ± P while potentially identifying determinants to human milk feeding. This study provides insight into infant and maternal characteristics that may be associated with barriers to human milk feeding.
Collapse
Affiliation(s)
- Neda Tahmasebifard
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC
| | - Jamie L Perry
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC
| | - Kevin O'Brien
- Department of Public Health, East Carolina University, Greenville, NC
| | - Patrick M Briley
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC
| |
Collapse
|
6
|
Saucedo Baza A, Mignacca C, Delgado PE, Paterniti TA, Romero de Mello Sa S, Looney S, Zahler-Miller C. A Technological Approach to Improved Breastfeeding Rates and Self-Efficacy: A Randomized Controlled Pilot Study. J Hum Lact 2023; 39:679-687. [PMID: 37571838 DOI: 10.1177/08903344231190625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
BACKGROUND Breastfeeding confers significant maternal and infant benefits; however, breastfeeding rates remain suboptimal in the United States. A parent's decision to breastfeed is influenced by non-modifiable and modifiable factors, including breastfeeding knowledge and self-efficacy. There is a positive correlation between high maternal self-efficacy and breastfeeding duration. Parents increasingly rely on technology for health information. RESEARCH AIM To determine if a smartphone application affected maternal self-efficacy and breastfeeding exclusivity rates. METHOD This study was a randomized, controlled pilot study examining the effect of an educational program, included in a smartphone application, on breastfeeding self-efficacy (assessed in postpartum Week 1 and Weeks 4-6) and breastfeeding rates (assessed in postpartum Weeks 4-6). Forty participants were recruited using block randomization to intervention (17 of 20 completed the study) and usual care (19 of 20 completed the study) groups. To examine the pre-test/post-test difference in the Breastfeeding Self-Efficacy Scale - Short Form total scores, a change in score (post-intervention minus pre-intervention) was calculated for each parent. RESULT The intervention group (phone application and usual care) showed greater change in self-efficacy scores (M = 7.6, SD = 7.8) compared to the control group (usual care; M = 1.2, SD = 3.7, p = .001). The rate of exclusive breastfeeding was nearly twice as high in the intervention group as in the control group, but did not reach statistical significance (p = .093). CONCLUSION The investigators found enhanced breastfeeding self-efficacy and breastfeeding rates among postpartum women receiving a smartphone educational program in the first 6 weeks postpartum. Further studies on smartphone interventions will develop our understanding of this technology in improving breastfeeding rates.
Collapse
Affiliation(s)
- Areli Saucedo Baza
- Medical College of Georgia, Augusta, GA, USA
- Department of Obstetrics and Gynecology, WellStar Kennestone Regional Medical Center, Marietta, GA, USA
| | | | - Paula E Delgado
- Medical College of Georgia, Augusta, GA, USA
- Department of Obstetrics & Gynecology, University of New Mexico, Albuquerque, NM, USA
| | | | | | | | | |
Collapse
|
7
|
Tahmasebifard N, Briley PM, Ellis C, Perry JL. Early Nutrition among Infants Admitted to the NICU with Cleft Lip and Palate. Cleft Palate Craniofac J 2023; 60:299-305. [PMID: 34812064 DOI: 10.1177/10556656211059371] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE The objective of this study was to examine differences in human milk feeding outcomes among infants admitted to a neonatal intensive care unit (NICU) with and without cleft lip and palate (CLP). METHOD Data were used from a sample of infants admitted to the NICU with and without CLP from the 2018 National Vital Statistics System. For baseline comparisons, Chi-square tests of independence were used to compare categorical variables, and independent samples t tests were used for continuous variables. Logistic regression models were performed to determine the odds of human milk feeding at discharge in infants admitted to the NICU with CLP. RESULTS The total sample included 345,429 infants admitted to the NICU, of which 660 had CLP. Significant differences were found among the following variables when baseline comparisons were made between infants admitted to the NICU with and without CLP: mother's race, mother's education, maternal smoking record, childbirth delivery method, presence of maternal pre-pregnancy diabetes, five-minute APGAR score, multiparity record (having more than one baby at birth), gestational age, and gestational weight. After controlling for baseline differences, results indicated reduced odds of human milk feeding at discharge in infants admitted to the NICU with CLP compared to those without CLP (OR = .543; 95% CI.455,.648). CONCLUSION Results suggest reduced odds of human milk feeding at discharge among infants admitted to the NICU with CLP compared to those without CLP. These findings emphasize the necessity of awareness and facilitation of human milk feeding in this population.
Collapse
Affiliation(s)
- Neda Tahmasebifard
- Department of Communication Sciences & Disorders, 3627East Carolina University, Greenville, USA
| | - Patrick M Briley
- Department of Communication Sciences & Disorders, 3627East Carolina University, Greenville, USA
| | - Charles Ellis
- Department of Speech, Language, and Hearing Sciences, University of Florida, USA
| | - Jamie L Perry
- Department of Communication Sciences & Disorders, 3627East Carolina University, Greenville, USA
| |
Collapse
|
8
|
A Cross-Sectional Study of the Nutritional Status of Infants with Orofacial Clefts in the First 6 Months of Life. J Pediatr 2022; 255:181-189.e3. [PMID: 36462686 DOI: 10.1016/j.jpeds.2022.11.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/25/2022] [Accepted: 11/03/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVE(S) To estimate nutritional status in a large cohort of infants with orofacial clefts in the US, overall and by cleft type from birth to 6 months of age. STUDY DESIGN We conducted a cross-sectional study in infants with orofacial clefts by examining growth by month between birth and 6 months of age. Infants with at least one weight measurement at a single US regional tertiary care pediatric hospital with an interdisciplinary cleft team between 2010 and 2020 were included. We calculated the average weight-for-age z scores and weight-for-length z scores. We calculated the proportion of infants underweight and wasting with z scores below -2 SDs monthly from birth to 6 months of age. We used t tests to compare the distribution of weight for age z-score and weight for length z-score among children with orofacial clefts to a normal distribution. RESULTS We included 883 infants with orofacial clefts. Compared with expected proportion of underweight infants (2.3%), a larger proportion of infants with orofacial clefts were underweight between birth and 1 month (10.6%), peaking between 2 and 3 months (27.1%), and remaining high between 5 and 6 months (16.3%). Compared with the expected proportion of infants with wasting (2.3%), a higher proportion of infants with orofacial clefts experienced wasting between birth and 1 month (7.3%), peaking between 2 and 3 months (12.8%), and remaining high between 5 and 6 months (5.3%). Similar findings were observed for all cleft types and regardless of comorbidities. CONCLUSION(S) A substantial proportion of infants with orofacial clefts compared with normative peers have malnutrition in the first 6 months of life in the US.
Collapse
|
9
|
Tsuchiya S, Tsuchiya M, Momma H, Aida J, Nagatomi R, Yaegashi N, Arima T, Igarashi K. Neurodevelopmental trajectories in children with cleft lip and palate: A longitudinal study based on the Japan Environment and Children's Study. Eur J Oral Sci 2022; 130:e12857. [PMID: 35166390 DOI: 10.1111/eos.12857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 01/17/2022] [Indexed: 01/31/2023]
Abstract
Cleft lip and/or palate (CL/P), the most prevalent congenital anomaly, is understood to negatively affect a wide range of child development. Since the concept remains controversial, because most published work is from cross-sectional studies, we examined the neurodevelopmental trajectories in participants with CL/P through a longitudinal comparison with the general population during early childhood using data from a nationwide birth cohort study in Japan. The linear mixed models for each domain of the Ages and Stages Questionnaire, third edition (ASQ-3), were used to detect differences in standardised mean scores between groups. The ASQ-3 is a general neurodevelopmental screening tool comprising communication, gross motor, fine motor, problem-solving, and personal-social domains. Participants' neurodevelopment was determined semi-annually from 6 to 36 months of age. The trajectories of standardised mean scores in each domain showed several significant differences between the control and CL/P groups, with the maximum difference at 24 months of age in the communication domain. Indeed, CL/P was associated with significantly lower scores in the communication (coefficient: -3.31, 95% CI: -5.09 to -1.14), problem-solving (coefficient: -3.13, 95% CI: -5.07 to -1.18), and personal-social domains (coefficient: -1.99, 95% CI: -3.87 to -0.11). Trajectories of ASQ-3 scores suggest neurodevelopmental delays in children with CL/P.
Collapse
Affiliation(s)
- Shinobu Tsuchiya
- Department of Orthodontics and Speech Therapy for Craniofacial Anomalies, Tohoku University Hospital, Sendai, Japan
| | | | - Haruki Momma
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryoichi Nagatomi
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Sendai, Japan.,Division of Biomedical Engineering for Health & Welfare, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynaecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takahiro Arima
- Department of Informative Genetics, Environment and Genome Research Centre, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kaoru Igarashi
- Department of Orthodontics and Speech Therapy for Craniofacial Anomalies, Tohoku University Hospital, Sendai, Japan.,Division of Craniofacial Anomalies, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | | |
Collapse
|
10
|
Stowe G, Schleif EP, Perry JL, Briley PM. Impact of Insurance Status on Initiation of Breast Milk Feeding Among Infants With CL ± P. Cleft Palate Craniofac J 2022:10556656221087553. [PMID: 35306864 DOI: 10.1177/10556656221087553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
To evaluate rates of breast milk feeding among infants with cleft lip with or without cleft palate (CL ± P) enrolled in Medicaid compared to Private Insurance/Self-Pay. This was a population-based retrospective cohort study. The 2018 US National Vital Statistics System-Natality component (NVSS-N) was used to examine nationwide birth certificate data. Infants with cleft lip with or without cleft palate and either Medicaid or Private Insurance/Self-Pay were included. Breast milk feeding rates among infants with CL ± P, as a function of insurance status. Chi-square tests of independence revealed that of 896 infants with CL ± P and insured by Medicaid, 527 (58.8%) were breast milk fed at discharge. Of 865 infants with CL ± P and insured by Private Insurance/Self-Pay, 621 (71.8%) were breast milk fed at discharge. Using logistic regression models and controlling for baseline demographic differences, results indicated that infants with CL ± P in the Medicaid group had reduced odds of breast milk feeding compared to the Private Insurance/Self-Pay group (OR = 0.08; 95% CI 0.56, 0.96). Breast milk support services are often necessary for the initiation of breast milk feeding among infants with CL ± P. However, these resources are likely not as readily available for those enrolled in Medicaid. These results suggest that infants with CL ± P, enrolled in Medicaid, may experience reduced breast milk feeding rates due to limited resources to initiate breast milk feeding. Factors that may promote breast milk feeding among this population are discussed.
Collapse
Affiliation(s)
- Gabrielle Stowe
- Department of Communication Sciences & Disorders, College of Allied Health Sciences, 3627East Carolina University, Greenville, NC, USA
| | - Eshan P Schleif
- Department of Communication Sciences & Disorders, College of Allied Health Sciences, 3627East Carolina University, Greenville, NC, USA
| | - Jamie L Perry
- Department of Communication Sciences & Disorders, College of Allied Health Sciences, 3627East Carolina University, Greenville, NC, USA
| | - Patrick M Briley
- Department of Communication Sciences & Disorders, College of Allied Health Sciences, 3627East Carolina University, Greenville, NC, USA
| |
Collapse
|
11
|
Penny C, McGuire C, Bezuhly M. A Systematic Review of Feeding Interventions for Infants with Cleft Palate. Cleft Palate Craniofac J 2021; 59:1527-1536. [PMID: 34714161 DOI: 10.1177/10556656211051216] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Various devices and techniques have been proposed to reduce feeding difficulties experienced by infants with cleft palate. The aim of this review is to identify and assess the scope and quality of evidence for these interventions. METHODS A systematic review of published literature evaluating feeding interventions for infants with cleft palate (with or without cleft lip) from database inception to 2021 was conducted using Preferred Reporting Items for Systematic Reviews guidelines. Quality appraisal of included studies was conducted using a methodological index for nonrandomized studies, Cochrane, or a measurement tool to assess systematic reviews 2 instruments, according to study type. RESULTS Fourteen studies met inclusion criteria, with the majority (71%) of studies consisting of second-level evidence. Included interventions were specialty bottles (21%), alternative feeding delivery systems (14%), obturators (14%), and educational programs (14%). Specialty bottles and palatal obturators did not appear to offer any substantial growth advantages compared to traditional bottles or no intervention, respectively. Designated education programs for the mothers of infants with clefts had a positive impact on infant growth. CONCLUSIONS Overall evidence evaluating feeding interventions for infants with cleft palate was moderate to low. While it does not appear that specialized feeding delivery systems or palatal obturators significantly improve growth in infants with clefts compared to children without cleft conditions, education programs do appear to be beneficial.
Collapse
Affiliation(s)
- Cameron Penny
- 12361Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | |
Collapse
|
12
|
Namchaitaharn S, Pimpiwan N, Saengnipanthkul S. Breastfeeding Promotion and Nursing Care for Infants with Cleft Palate and/or Cleft Lip in Northeastern Craniofacial Center, Thailand. Open Nurs J 2021. [DOI: 10.2174/1874434602115010149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
The common feeding problems in infants with Cleft Palate (CP) and/or Cleft Lip and Palate (CLP) are the inability to suck and swallow breastmilk. Difficulties in feeding may compromise normal growth and disrupt the bonding process.
Objective:
To evaluate the treatment and breastfeeding rate in infants with CP and CLP.
Methods:
A retrospective study of infants with CP and CLP who were admitted to the postpartum ward between July 2017 and June 2019 was conducted. Demographic data, type of feeding, nursing activities, and duration of breastfeeding after discharge were collected.
Results:
A total of 35 infants were included in the study. Twenty-seven cases were non-syndromic complete CLP (77.2%). On admission only 15 infants (42.8%) received breastmilk and alternative feeding techniques were applied for 26 (74.3%) infants. Breastfeeding promotion and nursing care were provided to mothers and infants by an interdisciplinary team at the Craniofacial Center. The median Length of Stay (LOS) was 8 days (range 5-9 days) and infants born at the affiliated hospital (inborn) had a significantly shorter LOS compared to infants referred from other health centers (p=0.019). None of the inborn groups received infant formula. The breastfeeding rate in all groups was 100% at discharge. Exclusive breastfeeding rates at 2-, 4-, and 6-months follow-up were 82.8%, 42.8%, and 31.4%, respectively.
Conclusion:
Breastfeeding promotion, education, and nursing care from an interdisciplinary team resulted in an improved ability of mothers to breastfeed infants with CLP, particularly in non-syndromic CLP. The exclusive breastfeeding rate after 6-months in this study was higher than in previous studies.
Collapse
|
13
|
Madhoun LL, Crerand CE, O'Brien M, Baylis AL. Feeding and Growth in Infants With Cleft Lip and/or Palate: Relationships With Maternal Distress. Cleft Palate Craniofac J 2020; 58:470-478. [PMID: 32924577 DOI: 10.1177/1055665620956873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine relationships between early feeding and growth and maternal distress in infants with and without cleft lip and/or palate (CL/P). DESIGN Cross-sectional. SETTING Pediatric academic medical center in the Midwestern United States. PARTICIPANTS Mothers of infants 1 to 12 weeks old with CL/P (n = 30) and without CL/P (control group, n = 30) were recruited at craniofacial clinic or pediatrician appointments. MAIN OUTCOME MEASURE(S) Maternal responses on the Feeding/Swallowing Impact Survey (FS-IS), Parenting Stress Index, Fourth Edition, Short Form (PSI-4-SF), and Edinburgh Postnatal Depression Scale. Infant feeding history and growth measurements were obtained. RESULTS Having an infant with CL/P revealed greater impact on maternal health-related quality of life due to feeding problems (F = 4.83, P = .03). Mothers of infants with CL/P reported average range Total Stress scores on the PSI-4-SF, which were higher than controls (F = 4.12, P = .05). Edinburgh Postnatal Depression Scale scores did not differ between groups. Compared to controls, infants with cleft palate had lower percentiles for weight (t = 4.13, P = .04) and length (t = 2.93, P = .01). Higher FS-IS scores were associated with longer feeding duration (r = 0.32, P = .01) and lower weight (r = -0.31, P = .02) and length (r = -0.32, P = .02). CONCLUSIONS Despite receiving early team care and feeding interventions, mothers of infants with CL/P reported higher stress and more challenges with feeding and growth. Future studies should examine targeted psychosocial interventions to improve feeding and growth outcomes in infants with CL/P.
Collapse
Affiliation(s)
- Lauren L Madhoun
- Department of Plastic and Reconstructive Surgery, 2650Nationwide Children's Hospital, Columbus, OH, USA.,Department of Plastic and Reconstructive Surgery, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Canice E Crerand
- Department of Plastic and Reconstructive Surgery, 2650Nationwide Children's Hospital, Columbus, OH, USA.,Department of Plastic and Reconstructive Surgery, The Ohio State University College of Medicine, Columbus, OH, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.,Center for Biobehavioral Health, The Abigail Wexner Research Institute at 2650Nationwide Children's Hospital, Columbus, OH, USA
| | - Meghan O'Brien
- Department of Plastic and Reconstructive Surgery, 2650Nationwide Children's Hospital, Columbus, OH, USA
| | - Adriane L Baylis
- Department of Plastic and Reconstructive Surgery, 2650Nationwide Children's Hospital, Columbus, OH, USA.,Department of Plastic and Reconstructive Surgery, The Ohio State University College of Medicine, Columbus, OH, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.,Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, USA
| |
Collapse
|
14
|
Tsuchiya S, Tsuchiya M, Momma H, Koseki T, Igarashi K, Nagatomi R, Arima T, Yaegashi N. Association of cleft lip and palate on mother-to-infant bonding: a cross-sectional study in the Japan Environment and Children's Study (JECS). BMC Pediatr 2019; 19:505. [PMID: 31862001 PMCID: PMC6923825 DOI: 10.1186/s12887-019-1877-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 12/05/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Cleft lip and/or palate is among the most prevalent congenital birth defects, and negatively affects maternal psychological status and may consequently result in higher prevalence of child maltreatment. However, the association of childbirths of infants with cleft lip and/or palate with maternal emotional involvement still remains unclear. We examined the association between childbirths of infants with cleft lip and/or palate and mother-to-infant bonding, using data from the Japan Environment and Children's Study, a nationwide birth cohort study. METHODS A cross-sectional study using the jecs-an-20,180,131 dataset was performed. A total 104,065 fetuses in 15 regional centres in Japan were enrolled after obtaining informed written consent. The Mother-to-Infant Bonding Scale, a self-report scale consisting of 10 items, was used to evaluate maternal bonding at one year after childbirth. Finally, the participants consisted of 79,140 mother-infant pairs, of which 211 mothers of infants with cleft lip and/or palate were included in our analyses. Multivariable logistic regression analysis using multiple imputation for missing data was performed to calculate the odds ratio and 95% confidence interval in the estimation of the association between bonding disorders and childbirths with cleft lip and/or palate. RESULTS No increased risk of bonding disorders was observed among all the mothers of infants with cleft lip and/or palate (odds ratio [95% confidence interval]; 0.97 [0.63-1.48], p = 0.880), however, advanced maternal age or multiple parity may adversely affect the associations between bonding disorders and cleft lip and/or palate, respectively. After stratification with a combination of maternal age and parity, a significant association of cleft lip and/or palate with bonding disorders was found only among advanced-age multiparae (odds ratio [95% confidence interval] = 2.51 [1.17-5.37], p = 0.018), but it was weakened after additional adjustment for maternal depression. CONCLUSIONS Childbirths of infants with cleft lip and/or palate may increase the risk of bonding disorders among advanced-age multiparae, possibly through maternal depression. This finding provides valuable information for the provision of multidisciplinary cleft care.
Collapse
Affiliation(s)
- Shinobu Tsuchiya
- Department of Orthodontics and Speech Therapy for Craniofacial Anomalies, Tohoku University Hospital, Sendai, Miyagi, 980-8574, Japan
| | - Masahiro Tsuchiya
- Department of Nursing, Tohoku Fukushi University, 6-149-1 Kunimi-ga-oka, Aoba-ku, Sendai, Miyagi, 981-3201, Japan.
| | - Haruki Momma
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8575, Japan
| | - Takeyoshi Koseki
- Division of Preventive Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, 980-8575, Japan
| | - Kaoru Igarashi
- Department of Orthodontics and Speech Therapy for Craniofacial Anomalies, Tohoku University Hospital, Sendai, Miyagi, 980-8574, Japan
- Division of Craniofacial Anomalies, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, 980-8575, Japan
| | - Ryoichi Nagatomi
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8575, Japan
- Division of Biomedical Engineering for Health & Welfare, Tohoku University Graduate School of Biomedical Engineering, Sendai, Miyagi, 980-8575, Japan
| | - Takahiro Arima
- Department of Informative Genetics, Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8575, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8575, Japan
| |
Collapse
|
15
|
Madhoun LL, Crerand CE, Keim S, Baylis AL. Breast Milk Feeding Practices and Barriers and Supports Experienced by Mother–Infant Dyads With Cleft Lip and/or Palate. Cleft Palate Craniofac J 2019; 57:477-486. [DOI: 10.1177/1055665619878972] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: To examine trends in breast milk provision and to characterize the breast milk feeding practices experienced by mother–infant dyads with cleft lip and/or palate (CL/P) in a large US sample. Design: Cross-sectional study. Methods: An online survey was distributed through cleft-related social media sites in the United States and in a single cleft lip and palate clinic. Statistical analyses included Kruskal-Wallis H tests and post hoc Mann-Whitney tests to examine group differences based on cleft type and prenatal versus postnatal cleft diagnosis. Linear regression was used to estimate associations between obtained variables. Participants: One hundred fifty biological mothers of infants (8-14 months of age) with CL/P (15% cleft lip, 29% cleft palate, 56% cleft lip and palate). Results: Forty-six percent of mothers of infants with CL/P provided breast milk to their infant for at least 6 months. Five percent of infants ever fed at breast, and 43% received pumped breast milk via bottle. The most commonly reported supports included lactation consultants, nurses, feeding therapists, and online support groups. Feeding therapy was received by 48% of infants. Conclusions: A lower percentage of mothers of infants with CL/P reported providing breast milk compared to national estimates of the general population of infants without clefting. Results suggested there are multiple barriers, as well as numerous medical and psychosocial supports that facilitated breast milk feeding success. Implications for care are discussed.
Collapse
Affiliation(s)
- Lauren L. Madhoun
- Division of Clinical Therapies, Nationwide Children’s Hospital, Columbus, OH, USA
- Cleft Lip and Palate Center and Center for Complex Craniofacial Disorders, Section of Plastic and Reconstructive Surgery, Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, USA
| | - Canice E. Crerand
- Cleft Lip and Palate Center and Center for Complex Craniofacial Disorders, Section of Plastic and Reconstructive Surgery, Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Plastic Surgery, The Ohio State University College of Medicine, OH, USA
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Sarah Keim
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Adriane L. Baylis
- Cleft Lip and Palate Center and Center for Complex Craniofacial Disorders, Section of Plastic and Reconstructive Surgery, Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, USA
- Department of Plastic Surgery, The Ohio State University College of Medicine, OH, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA
| |
Collapse
|
16
|
Boyce JO, Reilly S, Skeat J, Cahir P. ABM Clinical Protocol #17: Guidelines for Breastfeeding Infants with Cleft Lip, Cleft Palate, or Cleft Lip and Palate-Revised 2019. Breastfeed Med 2019; 14:437-444. [PMID: 31408356 DOI: 10.1089/bfm.2019.29132.job] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A central goal of the Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.
Collapse
Affiliation(s)
- Jessica O Boyce
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Australia
- Speech and Language Group, Murdoch Children's Research Institute, Melbourne, Australia
| | - Sheena Reilly
- Speech and Language Group, Murdoch Children's Research Institute, Melbourne, Australia
- Menzies Health Institute Queensland, Griffith University, Southport, Australia
| | - Jemma Skeat
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Australia
| | - Petrea Cahir
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| |
Collapse
|